Nursing Elites

1. The healthcare provider is applying a topical corticosteroid to a client with eczema. The healthcare provider should monitor for the potential of increased systemic absorption of the medication if the medication were being applied to which of the following body areas?

• A. Back
• B. Axilla
• C. Soles of the feet
• D. Palms of the hands

Correct answer: B

Rationale: The axilla has thinner skin, making it more permeable to topical medications. Areas with thinner skin, like the axilla, allow for higher systemic absorption of topical corticosteroids.

2. A client receives a prescription for methocarbamol (Robaxin), and the nurse reinforces instructions to the client regarding the medication. Which client statement would indicate a need for further instructions?

• A. My urine may turn brown or green.
• B. This medication is prescribed to help relieve my muscle spasms.
• C. If my vision becomes blurred, I need to be concerned about it.
• D. I need to call my doctor if I experience nasal congestion from this medication.

Correct answer: C

Rationale: The correct answer is C because blurred vision is an adverse effect of methocarbamol (Robaxin) and should be reported to a healthcare provider. Choices A, B, and D are all correct statements. Option A informs the client about a possible discoloration of urine, which is a known side effect. Option B correctly explains the purpose of the medication. Option D correctly advises the client to contact their doctor if they experience nasal congestion, which could indicate an adverse reaction.

3. A client who had a kidney transplant is receiving therapy with cyclosporine (Sandimmune). Which statement by the client indicates a need for further instruction?

• A. I need to obtain a yearly influenza vaccine.
• B. I need to have dental checkups every 3 months.
• C. I need to self-monitor my blood pressure at home.
• D. I need to call the health care provider (HCP) if my urine volume decreases or my urine becomes cloudy.

Correct answer: A

Rationale: The correct answer is A. Cyclosporine is an immunosuppressant that can reduce the effectiveness of vaccines. Clients should avoid vaccinations without consulting their health care provider to prevent potential complications or reduced efficacy of the vaccines.

4. A client with a prescription to take theophylline (Theo-24) daily has been given medication instructions by the nurse. The nurse determines that the client needs further information about the medication if the client states that he or she will:

• A. Drink at least 2 L of fluid per day.
• B. Take the daily dose at bedtime.
• C. Avoid changing brands of the medication without health care provider (HCP) approval.
• D. Avoid over-the-counter (OTC) cough and cold medications unless approved by the HCP.

Correct answer: B

Rationale: The correct answer is B. Taking theophylline at bedtime is inappropriate because it can cause insomnia. The medication should be taken early in the morning to avoid disrupting sleep patterns. It is important to follow the healthcare provider's instructions regarding the timing of the medication to achieve optimal therapeutic effects.

5. A client is taking docusate sodium (Colace). The nurse monitors which of the following to determine whether the client is experiencing a therapeutic effect from this medication?

• A. Abdominal pain
• B. Reduction in steatorrhea
• C. Hematest-negative stools
• D. Regular bowel movements

Correct answer: D

Rationale: The therapeutic effect of docusate sodium (Colace) is to soften stools and promote regular bowel movements, making option D the correct choice. Monitoring for regular bowel movements would indicate that the medication is working as intended by relieving or preventing constipation. Options A, B, and C are not directly related to the therapeutic effect of docusate sodium. Abdominal pain (option A) is a symptom that might indicate a problem rather than a therapeutic effect. Reduction in steatorrhea (option B) and Hematest-negative stools (option C) are not specific outcomes associated with docusate sodium.

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